先腹大，后四肢肿，为胀。或独腹大，四肢不肿者，治法同。
〔无〕附子绿豆汤 治寒客皮肤，壳壳然而坚，腹大身肿，按之陷而不起，色不变，病名肤胀。一剂
未知，再作。
大附子（一个，重七钱者，生，去皮脐，半破） 绿豆（二两）
上以生姜二两切，水二碗煎至一碗，去渣，分三服，空腹温服。次日，将前附子破作四片，再用绿豆
二两，姜一两，如前煎服。停三日，复将附子作八片，如前煎服。
（治鼓胀法，并见后行湿寒热气血诸条，皆其法也。）
〔仲〕胀满，按之不痛为虚，痛者为实，可下之。腹胀时减，复如故，此为寒，当与温药。腹满不减，减
不足言，须当下之，宜大承气汤。
〔海〕脾虚满者，黄 汤。（芍药停湿。）脾实满不运，平胃散。（苍术泄湿。）
东垣云∶腹胀满，气不转者，加浓朴以破滞气。腹中夯闷，此非腹胀满，乃散而不收，可加芍药收之。是
知气结而胀，宜浓朴散之；散而胀，宜芍药收之。
〔丹〕鼓胀，大补中气行湿。此乃脾虚之甚，必须远音乐，断浓味。朝宽暮急，血虚；暮宽朝急，气虚；
终日急，气血皆虚。用大剂人参、白术，佐以陈皮、苍术、茯苓之类。有血虚者，四物行血，随证加减。凡补
气，必带浓朴宽满。腹胀必少佐浓朴者，盖浓朴味辛，以气聚于上焦故也。气不运，加木香。气若陷下，用升
麻、柴胡以提其气。水肿当补脾为主，白术、茯苓、陈皮佐之。
鼓胀论 心肺阳也，居上；肾肝阴也，居下；脾居中亦阴也，属土。经曰∶饮食入胃，游溢精气，上输干
脾。脾气散精，上归于肺。通调水道，下输膀胱。水精四布，五经并行。是脾具坤静之德，而有干健之运，故
能致心肺之阳，降肾肝之阴，升而成天地交之泰，是为无病之人。今也七情内伤，六淫外侵，饮食失节，房劳
致虚，脾土之阴受伤，转输之官失职。胃虽受谷，不能运化，故阳自升，阴自降，而成天地不交之否。于斯时
也，清浊相混，隧道壅塞，气化浊血瘀郁而为热；热留而久，气化成湿；湿热相生，遂成胀满，经曰鼓胀是也。
以其外虽坚满，中空无物，有似于鼓，其病胶固，难以治疗，故又名曰蛊。若虫侵蚀，有蛊之义。验之治法，
理宜补脾。又须养肺金以制木，使脾无贼邪之虑。滋肾水以制火，使肺得清化之令。却盐味以防助邪；断妄想，
远音乐，以保母气，无有不安。医者不察，病起于虚，急于取效， 能希赏。病者苦于胀急，喜行利药，以求
一时之快。不知宽得一日半日，其肿愈甚，病邪甚矣，真气伤矣，去死不远。古方惟禹余粮丸，又名石中黄丸，
又名紫金丸，制肝补脾，殊为切当。亦须随证，又须顺时加减用之为妙。
予友俞仁叔，儒而医，连得家难，年近五十得此疾，自制禹余粮丸服之。予诊其脉，弦涩而数，曰∶此丸
新制， 炼之火邪尚存，温热之药太多，宜自加减，不可执方。俞笑曰∶今人不及古人，此方不可加减。服之
一月，口鼻出血，色黑骨立而死。
杨兄年五十，性嗜酒，病疟半年，患胀病，自察必死来求治。诊其脉弦而涩，重则大。疟未愈，手足瘦而
腹状如蜘蛛。遂教以参、术为君，当归、川芎、芍药为臣，陈皮、黄连、浓朴、茯苓为佐，生甘草些少，作浓
汤饮之，一日定三帖。彼亦严守戒忌。一月后疟得汗而愈。又半月，小便长而胀愈。中间虽少有加减，大意只
是利气行湿。
又，陈氏年四十余，性嗜酒，大便时见血，于春间患胀，色黑而腹大，其形如鬼。诊其脉数而涩，重似弱。
予以四物加黄连、黄芩、木通、白术、陈皮、浓朴、生甘草作汤与之，近一年而安。一补气，一补血，余药大
率相出入，皆获安以保天寿。或曰∶气无补法，子何补气而获安？果有说以通之乎？予曰∶气无补法，乃世俗
之言也，盖气之为病，痞闷壅塞，似难于补，恐增病势。不思正气虚者，不能营运，邪滞所着而不去，所以为
病。《经》曰∶壮者气行则愈，怯者着而成病。苟或气怯不用补法，气何由行？或曰∶子之药审则审矣，何效
之迟也。病者久在床枕，将必厌子之迂而求速效者矣。予曰∶此病之起，或三五年，或十余年，根深势笃，欲
求速效，自求祸耳。知王道者，能治此病也。或曰∶胀病将终，不可与利药乎？予曰∶灼知其不因于虚，受病
亦浅，脾胃尚壮，积滞不固，而又有可下之证，亦宜略与疏导。若援张子和浚川散、禹功丸为例，行迅攻之策，
实所不敢。
潘可达女，年十九岁，禀受颇浓，患胸腹胀满，自用下药，利十数行，时胀无增减来求治。诊其脉皆大，
略按即散而无力，全无数意。予曰∶此有表证，反攻里，当死。赖禀受好，时又在室，尚可挽回，寿损矣。急
与四物汤加人参、白术、带白陈皮、炙甘草煎服。至半月后，病不退，又自用萝卜根种煎汤，澡浴两度，时肿
稍增。予曰∶表病攻里，已自难救，今又虚其表，事急矣。于前药去地黄、芍药，加黄 ，倍白术，大剂浓煎
汤饮；又吞人参白术丸。十日后，如初病时。又因吃难化物自利，以参、术为君，少加陈皮为佐，又与肉豆蔻、
诃子为君，山楂子为使，粥和作丸吞之，至四五十帖而安。
一男子年四十余，患疟久而腹胀，脉不数而微弦，重取则来不滑利，轻重又皆无力。遂与索氏三和汤三倍
加白术，入姜汁服之。数服而疟愈，小便利二三行，胀稍减。遂又小便短少，予作气血两虚，于前药内入人参、
牛膝、当归身尾作大剂料，百服而愈。
索氏三和汤三倍加白术方
白术 浓朴 陈皮（各三两） 木通（一两） 槟榔 紫苏（各二两） 甘草 海金沙 大腹皮 白茯苓
枳壳（各一两） 水煎服。
〔海〕调胃白术泽泻散 治痰病化为水气传变，水谷不能食。
白术（半斤） 泽泻 芍药 陈皮 茯苓 生姜 木香 槟榔（各一两）
上为末，治腹肿如神。若心下痞，加枳实。若心下盛，加牵牛。
〔仲〕心下坚大如盘，边如旋杯，水饮所作，枳术汤主之。
枳实（七个） 白术（二两）
上二味，以水五升，煮取三升，分温三服。腹中软，即当散也。
〔罗〕真定王君用，年一十九岁，病积，脐左连胁如覆杯，腹胀如鼓，多青络脉，喘不得卧。时值暑雨，
加之自利完谷，日晡潮热，夜有盗汗，求予往治之。脉得浮数，按之有力。谓病家曰∶凡治积，非有毒之剂攻
之则不可。今脉虚弱如此，岂敢以常法治之。遂投分渗益胃之剂，数服而便清自调；杂以升降阴阳、进食和气
而腹大减。胃气稍平，间以消积之剂，不月余，良愈。先师尝曰∶洁古老人有云∶养正积自除。譬如满座君子，
纵有一小人，自无容地。今令真气实，胃气强，积自消矣。
〔丹〕一妇人，年三十六岁，家贫多劳，性偏急。自七月断经后，八月小腹下有一块，偏左如拳，有时块
起即痛作，伏则势减。至半月后，腹渐肿胀，食减平时三分之二，无力，遇夜发热．天明即稍退，其脉得虚微
短弱涩，左尤甚。初与白术一斤，带白陈皮一斤，作二十帖服。以三圣膏贴块上，经宿则块软，再宿则块小。
旬日后食稍进，热减半，脉稍有力。又与白术一斤，带白陈皮半斤，酒当归身半斤，木通三两，每帖研桃仁九
粒。尽此剂，病悉除。
一妇人，年五十余岁，素好怒，因食烧猪肉，次早面胀，绝不思食，倦怠，六脉沉涩，独左豁大。余作体
虚有痰，气为痰所隔不得降，当以补虚利痰为主。每早以二陈汤加参、术大剂与一帖，服后探令吐出药。辰巳
时，复与索氏三和汤一倍加白术二帖。至睡后，以神佑七丸以挠其痰，去牵牛。如此服至一月而安矣。
金寿一安人，年七十一岁，好湿面，得带下病，亦恶寒淋沥。医与荷花须、柴胡等药，发热，所下愈多。医
与缩砂、豆蔻药，以其食少也；腹满胀，气喘，又与葶苈散，不应。又与禹余粮丸，病愈甚。医又与崇土散，亦不应。
予脉之，两手洪涩，轻则弦长而滑实，至是喘甚不得卧。此不是湿而酿成湿，在足太阴、阳明二经。水谷之气
为湿所抑，不得上升，遂成带下。理用升举之剂，以补气、和血吹之。而医反与涩燥，宜其展转身病。遂与人参
生肺之阴以拒火毒；白术以补胃气除湿热、行水道；桃仁去污生新；郁李仁行积水，以通草佐之；犀角屑解食
毒、消肿闷；槟榔治最高之气。作浓汤吞下保和丸药。又疑素浓养，有肉积，加阿魏小丸同咽之。四五日后，
积气渐消，肿渐下。又加补肾丸以生肾水之真阴。又两三日后，渐安而得睡，食有味矣。又两日后，加与点丸
以驱逐肺家之积热而愈。
一丈夫，脾有热，肾有虚，胃有积，得肿疾或进或退，口干或气喘。医连月，不退。脉软而细，以其形肥，
不以为忌。用∶
白术（四钱） 芍药 地黄（三钱） 连翘 当归（二钱） 青皮（二钱半） 人参 木通 羌活 黄芩（各一钱
半） 甘草 红花（些）
上分五帖，煎下保和丸。
杨生，年三十，因疟初安，淡食豆腐斋饭成胀，在膈上，小便赤少，不思食，口渴，脉弦而涩，此胃中有
瘀血。用∶
苏梗（三分） 木通（半钱） 白术（一钱半） 川芎 枳实 白芍（各五分） 甘草（二分，炙） 陈皮（五分）
浓朴（三分）
上研，益元散下保和丸五十粒。
一丈夫气上，肚或膨胀，此下虚所致。
陈皮（五钱） 人参 归须 白术 连翘（各三钱） 地黄 芍药（各二钱） 木通（一钱半） 甘草（五分）
上分五帖，煎下保和丸。
木香化滞汤
白豆蔻（仁） 陈皮 大腹子 白茯苓 砂仁 人参（各一钱） 青皮 槟榔 木香 姜黄（各二钱） 白术（一
钱） 甘草（炙，四分） 白檀（二分） 藿香叶（二分） 桔梗（五分）
上为细末，水一大盏二分，煎至一盏，稍热服；食前沸汤点服亦得。
上方，治因积滞成胀，皆以参、术、朴、通等煎汤，补虚行湿；下神佑、阿魏等丸消积，所谓攻补兼施
者也。
小温中丸 治胀。是脾虚不能运化，不可下之。
陈皮 半夏（汤泡，去皮脐） 神曲（炒） 茯苓（各一两） 白术（二两） 香附子（不要烘晒） 针砂（各
一两半，醋炒红） 苦参（炒） 黄连（炒。各半两） 甘草（三钱）
上为末。醋水各一盏，打糊为丸，如桐子大。每服七八十丸。白术六钱，陈皮一钱，生姜一片，煎汤吞下。
虚甚，加人参一钱。各用本方去黄连，加浓朴半两。忌口。病轻者，服此丸六七两，小便长；病甚者服一斤，
小便始长。
〔无〕禹余粮丸 治十种水气，脚膝肿，上气喘满，小便不利。但是水气，悉皆主之。（许学士及丹溪皆云∶
此方治膨胀之要药。）
蛇含石（大者三两以新铁铫盛，入炭火中烧，蛇黄与铫子一般红，用钳取蛇黄，倾入醋中，候冷取出，研极
细） 禹余粮（三两） 真针砂（五两，先以水淘净，炒干，入禹余粮一处，用米醋二升就铫内煮，醋干为度。
后用铫，并药入炭中烧红，钳出倾药净砖地上，候冷研细）
以三物为主，其次量人虚实入下项∶（治水多是取转。惟此方三物既非大戟、甘遂、芫花之比，又有下项药
扶持，故虚人老人亦可服）
羌活 木香 茯苓 川芎 牛膝（酒浸） 桂心 白豆蔻（炮） 大茴香（炒） 蓬术（炮） 附子（炮）
干姜（炮） 青皮 京三棱（炮） 白蒺藜 当归（酒浸一宿。各半两）
上为末，拌匀，以汤浸蒸饼捩去水，和药再捣极匀，丸如桐子大。食前，温酒、白汤送下三十丸至五十丸。
最忌盐，一毫不可入口，否则发疾愈甚。但试服药，即于小便内旋去，不动脏腑。病去，日三服。兼以温和
调补气血药助之，真神方也。
〔丹〕脉坚实，人壮盛者，或可用攻药，便收拾白术为主。
〔垣〕中满治法，开鬼门、洁净府。开鬼门者，发汗也；洁净府，利小便也。又中满者泻之于内，谓脾胃
有病，当令上下分消其气。下焦如渎，气血自然分化，不待泄滓秽，如或大实大满，大小便不利，从权以寒热
药下之。或伤酒、湿面，及味浓之物，膏粱之人，又或食已便卧，使湿热之气不得施化，致令腹胀满，此亦是
热胀也。治热胀、分消丸主之。
〔仲〕气分，心下坚，大如盘，边如旋杯，水饮所作，桂枝去芍加麻辛附子汤主之。
桂枝 生姜（三两） 甘草（一两） 大枣（十二个） 麻黄 细辛（各二两） 附子（一个，炮）
上七味，以水七升，煮麻黄去上沫，内诸药，煮取二升，分温三服。当汗出，如虫行皮中，即愈。
〔《圣》〕牛黄琥珀丸 治水肿腹大，气息不通危急者，神效。
牛黄 琥珀 椒目（沉水者） 葶苈（炒紫色。各三分） 昆布（洗，炙） 海藻（洗，炙。各一两一钱）
牵牛（炒） 桂（各一两）
上七味为末，另研葶苈如泥，一处拌匀，炼蜜丸如桐子大。每服十五丸，米饮下，以小便利为度，日再服。
腹部先肿大，随后四肢浮肿，这称为“胀”。如果只有腹部肿大而四肢不浮肿的，治疗方法相同。
〔朱丹溪〕附子绿豆汤：治疗寒邪客于皮肤，皮肤坚硬如壳，腹部肿大身体浮肿，按压后凹陷不起，肤色不变，病名叫做“肤胀”。服用一剂后若未见明显效果，可再次制作服用。
大附子（一个，重七钱的，生的，去皮和脐，半破开） 绿豆（二两）
以上药材用生姜二两切片，加水两碗，煎至一碗，去药渣，分三次服用，空腹温服。第二天，将之前的附子再破成四片，再用绿豆二两，生姜一两，按照前面的方法煎服。停药三天后，再将附子分成八片，按照前面方法煎服。
（治疗鼓胀的方法，并见后面关于行湿、寒、热、气、血等各条内容中，都是这些方法。）
〔张仲景〕腹部胀满，按压时不痛的属于虚证，痛的属于实证，可以使用泻下法。腹胀有时减轻，过一会儿又恢复原状，这是寒证，应当给予温性药物。腹部胀满持续不减，即使有轻微减轻也不足挂齿，必须使用泻下法，适宜用大承气汤。
〔李东垣〕脾虚导致的胀满，用黄耆建中汤类方。（芍药能停湿。）脾实导致胀满且运化失常，用平胃散。（苍术能泄湿。）
李东垣说：腹胀满，气机不转动的，加浓朴以破除滞气。腹中感觉沉重闷塞，这不是单纯的腹胀满，而是气散而不收敛，可以加芍药来收敛它。由此可知，气结导致胀满，宜用浓朴疏散；气散导致胀满，宜用芍药收敛。
〔朱丹溪〕治疗鼓胀，要大力补益中气并运行湿气。这是因为脾虚非常严重，必须远离音乐娱乐，断绝浓厚滋腻的食物。早晨症状轻傍晚重，是血虚；傍晚症状轻早晨重，是气虚；整天都急迫难受，是气血皆虚。使用大剂量的人参、白术，佐以陈皮、苍术、茯苓等药。有血虚情况的，用四物汤活血，随证加减。凡是补气，必定要带上浓朴以宽胸除满。治疗腹胀必须少佐浓朴，因为浓朴味辛，能针对气聚于上焦的情况。气机不运转，加木香。气若陷下，用升麻、柴胡来提升其气。水肿当以补脾为主，用白术、茯苓、陈皮佐助。
《鼓胀论》心肺属阳，位居上部；肾肝属阴，位居下部；脾居中位也属阴，五行属土。医经说：饮食进入胃，游溢精气，向上输送到脾。脾气散布精微，向上归于肺。通调水道，向下输送到膀胱。水液精微四布全身，五脏经脉并行。这说明脾具有坤卦静止的德行，同时具备乾卦健运的功能，所以能使心肺之阳下降，肾肝之阴上升，形成天地交泰的局面，这就是无病之人。如今因七情内伤，六淫外侵，饮食失节，房劳过度导致虚弱，脾土之阴受伤，负责转输的官职失职。胃虽然受纳谷物，但不能运化，所以阳气自升，阴气自降，形成天地不交的否塞状态。在这个时候，清浊之气相混，经络隧道壅塞，气化不利导致浊血瘀郁而生热；热停留久了，气化变成湿气；湿热相生，遂成胀满，医经所说的“鼓胀”就是这种病。因为它外表虽然坚满，中间却是空的，像鼓一样，病情胶固难治，所以又名“蛊”。就像虫子侵蚀物体一样，有蛊的含义。验证其治疗方法，理应补脾。又须养肺金以制约肝木，使脾没有贼邪的忧虑。滋补肾水以制约心火，使肺得到清化的命令。戒除盐味以防助长邪气；断绝妄想，远离音乐，以保养母气（脾为肺之母），就没有不安稳的道理。医生如果不明察，疾病起于虚损，却急于求效，希望能获得赏赐。病人苦于胀急，喜欢用泻利药，以求一时的痛快。不知道虽然放宽了一两天，但肿胀会更严重，病邪更盛，真气受损，离死不远了。古方中只有禹余粮丸，又名石中黄丸，又名紫金丸，能制肝补脾，非常恰当。但也必须随证候变化，顺应时节加减使用才妙。
我的朋友俞仁叔，既是儒生又是医生，接连遭遇家庭变故，年近五十得了这个病，自己制作禹余粮丸服用。我诊察他的脉象，弦涩而数，说：“这个丸药是新制的，煅炼过程中火邪尚存，温热药太多，应该自行加减，不可拘泥于原方。”俞仁叔笑着说：“今人不如古人，这个方子不可加减。”服用一个月后，口鼻出血，面色黑瘦骨立而死。
杨兄五十岁，性格嗜好饮酒，患疟疾半年，患上胀病，自知必死前来求治。诊察他的脉象弦而涩，重按则大。疟疾未愈，手足消瘦而腹部像蜘蛛一样肿大。于是教导他用参、术为君药，当归、川芎、芍药为臣药，陈皮、黄连、浓朴、茯苓为佐药，少量生甘草，煎成浓汤饮用，一天定三帖。他也严格遵守禁忌。一个月后疟疾通过出汗而痊愈。又过了半个月，小便通畅，胀病痊愈。中间虽有少许加减，大意只是利气行湿。
另外，陈氏四十多岁，性格嗜好饮酒，大便时常带血，在春季患胀病，面色黑而腹部肿大，形状像鬼。诊察他的脉象数而涩，重按似弱。我用四物汤加黄连、黄芩、木通、白术、陈皮、浓朴、生甘草煎汤给他服用，将近一年而安稳。一个是补气，一个是补血，其余药物大体相似出入，都获得了安宁并保全了天年。有人说：“气没有补法，你为什么补气而获安？果然有说法来解释吗？”我说：“气无补法，是世俗的说法，大概气作为病邪，痞闷壅塞，似乎难以补益，恐怕会增加病势。但不想正气虚者，不能营运，邪滞附着而不离去，所以才生病。《内经》说：‘壮者气行则愈，怯者着而成病。’如果气怯不用补法，气从哪里运行呢？”有人说：“你的药确实审慎，为什么见效这么慢？病人久卧床榻，必将厌倦你的迂阔而寻求速效的人。”我说：“这个病的起因，或三五年，或十余年，根深势重，想要追求速效，是自寻祸害啊。懂得王道治国道理的人，才能治好这个病。”有人说：“胀病将终，不可以给泻利药吗？”我说：“明确知道它不是由于虚损，受病也浅，脾胃还强壮，积滞不固，并且又有可下的证候，也适宜稍微给予疏导。如果援引张子和的浚川散、禹功丸为例，实行迅猛攻伐的策略，实在不敢苟同。
潘可达的女儿，十九岁，禀赋颇厚，患胸腹胀满，自己服用下药，腹泻十多次，时时胀满无增减前来求治。诊察她的脉象都大，略按即散且无力，完全没有数的意思。我说：“这有表证，反而攻里，应当死亡。幸好禀赋好，当时又在家未出嫁，还可以挽回，但寿命会受损。”急忙用四物汤加人参、白术、带白皮的陈皮、炙甘草煎服。到了半个月后，病不退，又自己用萝卜根种煎汤，洗澡两次，时时肿胀稍增。我说：“表病攻里，已经难以救治，现在又使其表虚，事情紧急了。”在前药中去掉地黄、芍药，加黄耆，加倍白术，大剂浓煎汤饮；又吞服人参白术丸。十日后，恢复到初病时的状态。又因为吃了难消化的食物导致自利，以参、术为君药，少量加陈皮为佐药，又与肉豆蔻、诃子为君药，山楂子为使药，用粥调和做成丸吞服，到了四五十帖而安稳。
一个男子四十多岁，患疟疾久而腹胀，脉不数而微弦，重取则来不滑利，轻重按都无力。于是给予索氏三和汤三倍量加白术，加入姜汁服用。几服后疟疾痊愈，小便通利二三行，胀稍减。随后又小便短少，我认为这是气血两虚，在前药中加入人参、牛膝、当归身尾做大剂料，服用百帖而愈。
索氏三和汤三倍加白术方
白术 浓朴 陈皮（各三两） 木通（一两） 槟榔 紫苏（各二两） 甘草 海金沙 大腹皮 白茯苓 枳壳（各一两） 水煎服。
〔李东垣〕调胃白术泽泻散：治疗痰病化为水气传变，水谷不能进食。
白术（半斤） 泽泻 芍药 陈皮 茯苓 生姜 木香 槟榔（各一两）
以上研为末，治疗腹肿如神。如果心下痞满，加枳实。如果心下盛满，加牵牛。
〔张仲景〕心下坚硬大如盘，边缘像旋转的杯子，这是水饮所作，用枳术汤主治。
枳实（七个） 白术（二两）
以上两味药，用水五升，煮取三升，分三次温服。腹中变软，说明病邪已散。
〔罗谦甫〕真定王君用，年龄十九岁，患积聚病，脐左连胁部像倒扣的杯子，腹胀如鼓，青色络脉多，喘促不能卧。当时正值暑雨，加之自利完谷不化，日晡潮热，夜间盗汗，请求我去诊治。脉得浮数，按之有力。我对病家说：“凡治疗积聚，非用有毒之剂攻伐不可。如今脉象虚弱如此，岂敢用常法治之。”于是投予分渗益胃的药剂，几服后大便清利自然调畅；杂以升降阴阳、进食和气的药物而腹部大大减小。胃气稍平，间或用消积的药剂，不到一个多月，痊愈。先师曾说：洁古老人说过：“养正积自除。”譬如满座君子，纵然有一个小人，自然没有容身之地。如今令真气实，胃气强，积聚自然消除。
〔朱丹溪〕一个妇人，三十六岁，家贫多劳作，性格偏急躁。从七月断经后，八月小腹下有一块，偏左如拳头大小，有时肿块起来就疼痛发作，伏卧则势头减轻。到半月后，腹部逐渐肿胀，食量减少平时的三分之二，无力，遇夜发热，天明即稍退，脉象得虚微短弱涩，左侧尤其甚。起初给予白术一斤，带白皮的陈皮一斤，作二十帖服用。用三圣膏贴在肿块上，过夜则肿块变软，再宿则肿块变小。十日后食量稍进，热减半，脉稍有力。又给予白术一斤，带白皮的陈皮半斤，酒当归身半斤，木通三两，每帖研入桃仁九粒。服完此剂，病悉除。
一个妇人，五十多岁，素来好怒，因吃烧猪肉，次早面部肿胀，绝不思食，倦怠，六脉沉涩，唯独左侧豁大。我认为是体虚有痰，气被痰阻隔不得下降，应当以补虚利痰为主。每天早晨用二陈汤加参、术大剂给一帖，服后探喉令吐出药。辰巳时，再用索氏三和汤一倍量加白术两帖。到睡后，用神佑七丸以扰动其痰，去掉牵牛。如此服用至一月而安稳。
金寿一安人，七十一岁，喜好湿面，得带下病，也恶寒淋沥。医生给荷花须、柴胡等药，发热，所下之物更多。医生给缩砂、豆蔻药，因为她食少；腹满胀，气喘，又给葶苈散，不应。又给禹余粮丸，病更甚。医生又给崇土散，也不应。我诊察她的脉，两手洪涩，轻则弦长而滑实，至此喘甚不得卧。这不是湿而酿成湿，而是在足太阴、阳明二经。水谷之气为湿所抑，不得上升，遂成带下。理应用升举之剂，以补气、和血吹之。而医生反用涩燥药，宜其辗转生病。遂给人参生肺之阴以拒火毒；白术以补胃气除湿热、行水道；桃仁去污生新；郁李仁行积水，以通草佐之；犀角屑解食毒、消肿闷；槟榔治最高之气。作浓汤吞下保和丸药。又怀疑她素来浓养，有肉积，加阿魏小丸同咽之。四五日后，积气渐消，肿渐下。又加补肾丸以生肾水之真阴。又两三日后，渐安而得睡，食有味矣。又两日后，加与点丸以驱逐肺家之积热而愈。
一个丈夫，脾有热，肾有虚，胃有积，得肿疾或进或退，口干或气喘。医生连月治疗，不退。脉软而细，因为他形肥，不以为忌。用：
白术（四钱） 芍药 地黄（三钱） 连翘 当归（二钱） 青皮（二钱半） 人参 木通 羌活 黄芩（各一钱半） 甘草 红花（些）
以上分五帖，煎下保和丸。
杨生，三十岁，因疟疾初安，淡食豆腐斋饭成胀，在膈上，小便赤少，不思食，口渴，脉弦而涩，这是胃中有瘀血。用：
苏梗（三分） 木通（半钱） 白术（一钱半） 川芎 枳实 白芍（各五分） 甘草（二分，炙） 陈皮（五分） 浓朴（三分）
以上研末，益元散下保和丸五十粒。
一个丈夫气上逆，肚子或膨胀，这是下虚所致。
陈皮（五钱） 人参 归须 白术 连翘（各三钱） 地黄 芍药（各二钱） 木通（一钱半） 甘草（五分）
以上分五帖，煎下保和丸。
木香化滞汤
白豆蔻（仁） 陈皮 大腹子 白茯苓 砂仁 人参（各一钱） 青皮 槟榔 木香 姜黄（各二钱） 白术（一钱） 甘草（炙，四分） 白檀（二分） 藿香叶（二分） 桔梗（五分）
以上为细末，水一大盏二分，煎至一盏，稍热服；食前沸汤点服亦得。
上方，治疗因积滞成胀，都以参、术、朴、通等煎汤，补虚行湿；下神佑、阿魏等丸消积，所谓攻补兼施者也。
小温中丸：治疗胀。这是脾虚不能运化，不可用泻下法。
陈皮 半夏（汤泡，去皮脐） 神曲（炒） 茯苓（各一两） 白术（二两） 香附子（不要烘晒） 针砂（各一两半，醋炒红） 苦参（炒） 黄连（炒。各半两） 甘草（三钱）
以上为末。醋水各一盏，打糊为丸，如桐子大。每服七八十丸。用白术六钱，陈皮一钱，生姜一片，煎汤吞下。虚甚，加人参一钱。各方去掉黄连，加浓朴半两。忌口。病轻者，服此丸六七两，小便长；病甚者服一斤，小便始长。
〔朱震亨/朱丹溪〕禹余粮丸：治疗十种水气，脚膝肿，上气喘满，小便不利。只要是水气，都主治。（许学士及丹溪都说：此方治疗膨胀的要药。）
蛇含石（大的三两，用新铁铫盛，入炭火中烧，蛇含石黄与铫子一般红，用钳取蛇含石黄，倾入醋中，候冷取出，研极细） 禹余粮（三两） 真针砂（五两，先以水淘净，炒干，入禹余粮一处，用米醋二升就铫内煮，醋干为度。后用铫，并药入炭中烧红，钳出倾药净砖地上，候冷研细）
以这三物为主，其次根据人的虚实加入下列各项：（治水多是取转利。惟此方三物既非大戟、甘遂、芫花之比，又有下项药扶持，故虚人老人亦可服）
羌活 木香 茯苓 川芎 牛膝（酒浸） 桂心 白豆蔻（炮） 大茴香（炒） 蓬术（炮） 附子（炮） 干姜（炮） 青皮 京三棱（炮） 白蒺藜 当归（酒浸一宿。各半两）
以上为末，拌匀，以汤浸蒸饼捩去水，和药再捣极匀，丸如桐子大。食前，温酒、白汤送下三十丸至五十丸。
最忌盐，一毫不可入口，否则发疾愈甚。但试服药，即于小便内旋去，不动脏腑。病去，日三服。兼以温和调补气血药助之，真神方也。
〔李东垣〕中满治法，开鬼门、洁净府。开鬼门者，发汗也；洁净府，利小便也。又中满者泻之于内，谓脾胃有病，当令上下分消其气。下焦如渎，气血自然分化，不待泄滓秽，如或大实大满，大小便不利，从权以寒热药下之。或伤酒、湿面，及味浓之物，膏粱之人，又或食已便卧，使湿热之气不得施化，致令腹胀满，此亦是热胀也。治热胀、分消丸主之。
〔张仲景〕气分，心下坚，大如盘，边如旋杯，水饮所作，桂枝去芍加麻辛附子汤主之。
桂枝 生姜（三两） 甘草（一两） 大枣（十二个） 麻黄 细辛（各二两） 附子（一个，炮）
以上七味药，用水七升，煮麻黄去上沫，内诸药，煮取二升，分温三服。当汗出，如虫行皮中，即愈。
〔《太平圣惠方》〕牛黄琥珀丸：治疗水肿腹大，气息不通危急者，神效。
牛黄 琥珀 椒目（沉水者） 葶苈（炒紫色。各三分） 昆布（洗，炙） 海藻（洗，炙。各一两一钱） 牵牛（炒） 桂（各一两）
以上七味为末，另研葶苈如泥，一处拌匀，炼蜜丸如桐子大。每服十五丸，米饮下，以小便利为度，日再服。
The abdomen swells first, followed by edema of the four limbs; this is termed "Zhang" (Distension). If only the abdomen swells without edema in the four limbs, the treatment method is the same.
[Danxi] Fuzi Lutou Tang (Aconite and Mung Bean Decoction): Treats cold pathogen lodging in the skin, where the skin is hard like a shell, the abdomen is swollen and the body is edematous, pressing leaves an indentation that does not rise immediately, with unchanged skin color; the disease name is "Fuzhang" (Skin Distension). Take one dose; if unknown effect, prepare again.
Da Fuzi (One piece, weighing seven qian, raw, peeled of skin and umbilicus, half-broken) Lutou (Two liang)
Take Shengjiang (Fresh Ginger, two liang) sliced, add two bowls of water, decoct to one bowl, remove dregs, divide into three doses, take warm on an empty stomach. The next day, break the previous Fuzi into four pieces, use Lutou (Mung Bean, two liang), Jiang (Ginger, one liang), decoct and take as before. Stop for three days, then break the Fuzi into eight pieces, decoct and take as before.
(The methods for treating Guzhang [Drum Distension] are also seen in the following sections on moving dampness, cold, heat, qi, and blood; all are these methods.)
[Zhongjing] Abdominal fullness and distension: pressing without pain indicates deficiency; pain indicates excess, which can be treated with purgatives. Abdominal distension that reduces at times and returns to normal is Cold; give warming medicines. Abdominal fullness that does not reduce, or reduction is negligible, must be purged; Da Chengqi Tang (Major Order the Qi Decoction) is suitable.
[Hailan] Fullness due to Spleen deficiency: Huangqi Jianzhong Tang (Honeyed Cinnamon Twig Decoction modified with Astragalus) [Note: Text says "Huang ... Tang", likely referring to a formula containing Huangqi/Astragalus given context of Spleen deficiency, but strictly translating text "Huang ... Tang"]. (Shaoyao [Paeoniae Radix Alba] stops dampness.) Fullness due to Spleen excess with poor transport: Pingwei San (Calm the Stomach Powder). (Cangzhu [Atractylodis Rhizoma] drains dampness.)
Dongyuan said: For abdominal distension where qi does not move, add Houpo (Magnoliae Officinalis Cortex) to break stagnant qi. A feeling of heaviness and oppression in the abdomen is not simple distension, but qi scattering without gathering; add Shaoyao (Paeoniae Radix Alba) to gather it. Thus, distension due to qi knotting should be scattered with Houpo; distension due to qi scattering should be gathered with Shaoyao.
[Danchi] For Guzhang (Drum Distension), greatly tonify Middle Qi and move dampness. This is extreme Spleen deficiency; one must stay away from music/entertainment and cut off rich flavors. Morning relief and evening urgency indicate Blood deficiency; evening relief and morning urgency indicate Qi deficiency; constant urgency indicates both Qi and Blood deficiency. Use large doses of Renshen (Ginseng Radix et Rhizoma), Baizhu (Atractylodis Macrocephalae Rhizoma), assisted by Chenpi (Citri Reticulatae Pericarpium), Cangzhu (Atractylodis Rhizoma), Fuling (Poria), etc. For Blood deficiency, use Siwu Tang (Four Substances Decoction) to move blood, modify according to syndrome. Whenever tonifying Qi, always include Houpo (Magnoliae Officinalis Cortex) to widen the chest and relieve fullness. Treating abdominal distension requires a small amount of Houpo because Houpo is pungent and addresses qi gathering in the Upper Jiao. If qi does not move, add Muxiang (Aucklandiae Radix). If qi sinks, use Shengma (Cimicifugae Rhizoma) and Chaihu (Bupleuri Radix) to lift it. For edema, focus on tonifying the Spleen, assisted by Baizhu (Atractylodis Macrocephalae Rhizoma), Fuling (Poria), and Chenpi (Citri Reticulatae Pericarpium).
"Treatise on Drum Distension": Heart and Lung are Yang, residing above; Kidney and Liver are Yin, residing below; Spleen resides in the middle and is also Yin, belonging to Earth. The Classics say: Food enters the Stomach, its essence floats and overflows, transporting upwards to the Spleen. The Spleen scatters essence, sending it upwards to the Lung. It regulates water passages, transporting downwards to the Bladder. Water essence distributes throughout the four directions, and the five meridians proceed together. Thus, the Spleen possesses the stillness of Kun (Earth) and the movement of Qian (Heaven), enabling it to descend Heart/Lung Yang and ascend Kidney/Liver Yin, creating the harmony of Heaven and Earth interaction, which is the state of health. Now, internal injury from Seven Emotions, external invasion of Six Evils, irregular diet, or sexual exhaustion causing deficiency injures Spleen Yin. The official of transformation and transportation fails. Although the Stomach receives grain, it cannot transform and transport. Thus, Yang rises spontaneously, Yin descends spontaneously, creating the obstruction of non-interaction between Heaven and Earth. At this time, clear and turbid mix, tunnels become blocked, qi transformation fails, turbid blood stasis郁 (depresses) generating Heat; long-standing Heat transforms qi into Dampness; Dampness and Heat generate each other, resulting in distension, known as Guzhang. Although the exterior is hard and full, the interior is hollow, resembling a drum; the disease is stubborn and difficult to treat, hence also called "Gu" (Poison/Gu). Like insects eroding, it has the meaning of Gu. Verifying treatment methods, it is appropriate to tonify the Spleen. One must also nourish Lung Metal to control Liver Wood, so the Spleen has no fear of thief pathogens. Nourish Kidney Water to control Fire, so the Lung receives the command of clear transformation. Reject salt flavor to prevent aiding evil; cut off delusions, stay away from music, to preserve Mother Qi (Spleen is Mother of Lung), and there will be no instability. Physicians who do not observe that the disease arises from deficiency, yet seek quick effects hoping for reward... Patients suffering from distension and urgency prefer purgatives to seek temporary relief. They do not know that although relieved for a day or half-day, the swelling becomes worse, the pathogen is stronger, true Qi is injured, and death is near. Ancient formulas only have Yuyuliang Wan (Yiyu Liang Pill), also known as Shizhonghuang Wan or Zijin Wan, which controls Liver and tonifies Spleen, very appropriate. But one must modify according to syndrome and follow seasons for best results.
My friend Yu Renshu, a scholar and physician, suffered family tragedies, nearly fifty when he got this disease. He made Yuyuliang Wan himself and took it. I palpated his pulse: Wiry, Choppy, and Rapid. I said: "This pill is newly made, fire evil remains from calcination, too many warming/hot medicines; you should modify it yourself, do not stick to the formula." Yu smiled and said: "Modern people are inferior to ancients; this formula cannot be modified." After taking it for one month, bleeding from mouth and nose occurred, complexion turned black, emaciated, and he died.
Brother Yang, fifty years old, loved alcohol, had malaria for half a year, developed distension disease, came seeking treatment believing he would die. Pulse was Wiry and Choppy, heavy pressure made it Large. Malaria not cured, limbs thin, abdomen swollen like a spider. Taught him to use Renshen (Ginseng Radix et Rhizoma) and Baizhu (Atractylodis Macrocephalae Rhizoma) as Sovereign, Danggui (Angelicae Sinensis Radix), Chuanxiong (Ligustici Chuanxiong Rhizoma), Shaoyao (Paeoniae Radix Alba) as Ministers, Chenpi (Citri Reticulatae Pericarpium), Huanglian (Coptidis Rhizoma), Houpo (Magnoliae Officinalis Cortex), Fuling (Poria) as Assistants, small amount of Sheng Gancao (Raw Glycyrrhizae Radix et Rhizoma), decoct strong tea, drink, three doses per day. He strictly observed taboos. After one month, malaria cured via sweating. Half a month later, urination increased and distension cured. Minor modifications in between, main idea was promoting Qi and moving dampness.
Also, Mr. Chen, over forty, loved alcohol, stool sometimes had blood, developed distension in spring, dark complexion, abdomen large like a ghost. Pulse Rapid and Choppy, heavy pressure seemed Weak. I gave Siwu Tang (Four Substances Decoction) plus Huanglian (Coptidis Rhizoma), Huangqin (Scutellariae Radix), Mutong (Akebiae Caulis), Baizhu (Atractylodis Macrocephalae Rhizoma), Chenpi (Citri Reticulatae Pericarpium), Houpo (Magnoliae Officinalis Cortex), Sheng Gancao (Raw Glycyrrhizae Radix et Rhizoma) decocted. Stable for nearly a year. One tonified Qi, one nourished Blood, other herbs largely similar, all achieved peace and preserved natural lifespan. Someone asked: "Qi has no tonification method, why did your tonification bring peace? Is there a theory?" I said: "Qi has no tonification method is secular talk. Qi pathology involves stagnation and blockage, seemingly hard to tonify, fearing it increases disease. But consider: if Righteous Qi is deficient, it cannot circulate, pathogenic stagnation adheres and does not leave, thus causing disease. The Classic says: 'The robust recover as Qi moves; the timid develop disease as Qi sticks.' If Qi is timid and not tonified, how can Qi move?" Someone asked: "Your medicine is prudent, why slow effect? Patient bedridden, will tire of your slowness and seek speed." I said: "This disease starts, maybe 3-5 years, or 10+ years, deep root and strong momentum, seeking quick effect is seeking disaster. Those who understand the King's Way can cure this." Someone asked: "At end of distension disease, can we give purgatives?" I said: "If clearly not due to deficiency, shallow disease, Spleen/Stomach still strong, accumulation not fixed, and purgative indications exist, slight guidance is suitable. But citing Zhang Hezi's Xunchuan San or Yugong Wan for rapid attack, I dare not."
Pan Keda's daughter, 19, constitution rich, chest/abdominal fullness, self-administered purgatives, diarrhea 10+ times, distension unchanged, sought treatment. Pulse Large, disperses on light pressure, weak, no Rapid quality. I said: "Exterior syndrome present, attacking Interior, should die. Fortunately constitution good, unmarried, can recover, but lifespan reduced." Urgently gave Siwu Tang (Four Substances Decoction) plus Renshen (Ginseng Radix et Rhizoma), Baizhu (Atractylodis Macrocephalae Rhizoma), Chenpi with white pith (Citri Reticulatae Pericarpium), Zhi Gancao (Prepared Glycyrrhizae Radix et Rhizoma) decocted. After half month, disease not receding, self-used radish seed decoction for bath twice, swelling slightly increased. I said: "Exterior disease attacked Interior, already hard to save, now weakened Exterior, urgent." Removed Dihuang (Rehmanniae Radix) and Shaoyao (Paeoniae Radix Alba) from previous prescription, added Huangqi (Astragali Radix), doubled Baizhu (Atractylodis Macrocephalae Rhizoma), large dose strong decoction; swallowed Renshen Baizhu Wan (Ginseng and Atractylodes Pill). Ten days later, back to initial state. Then ate indigestible food causing self-diarrhea, used Renshen/Baizhu as Sovereign, small Chenpi as Assistant, Rou Doukou (Myristicae Semen) and Hezi (Terminalia Chebulae Fructus) as Sovereign, Shanzhazhi (Crataegi Fructus) as Envoy, mixed with congee into pills, swallowed. After 40-50 doses, stable.
Man, 40+, malaria prolonged, abdominal distension, pulse not Rapid but slightly Wiry, heavy pressure not slippery, light/heavy both weak. Gave Suoshi Sanhe Tang (Mr. Su's Three-Harmony Decoction) tripled with Baizhu (Atractylodis Macrocephalae Rhizoma), added Jiangzhi (Ginger Juice). Several doses, malaria cured, urination 2-3 times daily, distension slightly reduced. Then urine short, considered Qi and Blood dual deficiency, added Renshen (Ginseng Radix et Rhizoma), Niuxi (Achyranthis Bidentatae Radix), Danggui Shenwei (Angelicae Sinensis Radix tip and tail) to previous prescription, large dose, 100 doses, cured.
Suoshi Sanhe Tang Tripled with Baizhu Formula:
Baizhu (Atractylodis Macrocephalae Rhizoma), Houpo (Magnoliae Officinalis Cortex), Chenpi (Citri Reticulatae Pericarpium) (each 3 liang); Mutong (Akebiae Caulis) (1 liang); Binglang (Arecae Semen), Zisu (Perillae Folium) (each 2 liang); Gancao (Glycyrrhizae Radix et Rhizoma), Haijinsha (Lygodii Spora), Dafupi (Trogopterori Fructus), Baifuling (Poria cum Ligno Quercus), Zhike (Aurantii Fructus Immaturus) (each 1 liang). Decoct in water and take.
[Hailan] Tiaowei Baizhu Zexie San (Regulate Stomach Atractylodes and Alisma Powder): Treats Phlegm transforming into Water Qi transmission, unable to eat water/grain.
Baizhu (Atractylodis Macrocephalae Rhizoma) (8 liang); Zexie (Alismatis Rhizoma), Shaoyao (Paeoniae Radix Alba), Chenpi (Citri Reticulatae Pericarpium), Fuling (Poria), Shengjiang (Zingiberis Rhizoma Recens), Muxiang (Aucklandiae Radix), Binglang (Arecae Semen) (each 1 liang).
Powder above. Divine for abdominal swelling. If epigastric stuffiness, add Zhishi (Aurantii Fructus Immaturus). If epigastric fullness, add Qianniu (Pharbitidis Semen).
[Zhongjing] Epigastric hardness large as a plate, edge like a rotating cup, caused by Water Drink; Zhizhu Tang (Immature Bitter Orange and Atractylodes Decoction) governs.
Zhishi (Aurantii Fructus Immaturus) (7 pieces); Baizhu (Atractylodis Macrocephalae Rhizoma) (2 liang).
Two ingredients, water 5 sheng, boil to 3 sheng, divide warm, 3 doses. Abdomen soft, then dispersed.
[Luo] Wang Junyong of Zhending, 19 years old, Ji (Accumulation) disease, left of navel connecting to hypochondrium like inverted cup, abdomen distended like drum, many blue collaterals, panting unable to lie flat. Season hot rain, plus spontaneous diarrhea undigested food, afternoon tidal fever, night sweats, sought treatment. Pulse Floating and Rapid, forceful on pressure. Said to family: "Treating Ji requires toxic agents to attack. Now pulse so weak, dare not use ordinary method." Gave Fen Shen Yiwei (Separate Drainage Benefit Stomach) agent, several doses, stool clear and regulated; mixed with Sheng Jiang Yin Yang (Ascend Descend Yin Yang), Jing Shi He Qi (Nourish Food Harmonize Qi) agents, abdomen greatly reduced. Stomach Qi calmed, occasionally used Xiao Ji (Reduce Accumulation) agents, less than a month, well recovered. Master said: Jiegu Old Man said: "Nourish Righteousness, Accumulation removes itself." Like a room full of gentlemen, even one villain has no place. Now make True Qi solid, Stomach Qi strong, Accumulation disappears naturally.
[Danchi] Woman, 36, poor laborious, impatient nature. After menstruation stopped in July, August lump appeared lower abdomen, left like fist, painful when lump rises, relieved when lying down. Half month later, abdomen gradually swollen, appetite 2/3 normal, weak, night fever, morning subsides, pulse Deficient, Micro, Short, Weak, Choppy, Left worse. Initially gave Baizhu (Atractylodis Macrocephalae Rhizoma) 1 jin, Chenpi with white pith (Citri Reticulatae Pericarpium) 1 jin, 20 doses. Applied Sansheng Gao (Three Holy Ointment) to lump. Overnight lump soft, second night lump smaller. 10 days later, appetite improved, fever halved, pulse slightly forceful. Again gave Baizhu (Atractylodis Macrocephalae Rhizoma) 1 jin, Chenpi with white pith (Citri Reticulatae Pericarpium) 0.5 jin, Jiudanggui Shen (Wine-processed Angelicae Sinensis Radix Root Body) 0.5 jin, Mutong (Akebiae Caulis) 3 liang, per dose grind 9 Tao Ren (Persicae Semen). Finished this course, disease removed.
Woman, 50+, prone to anger, ate roasted pork, next morning facial swelling, no appetite, fatigue, six pulses Deep and Choppy, Left only Hollow and Large. Considered Body Deficiency with Phlegm, Qi blocked by Phlegm unable to descend, treat tonifying deficiency and draining phlegm primarily. Every morning Erchen Tang (Two-Cured Decoction) plus Renshen (Ginseng Radix et Rhizoma), Baizhu (Atractylodis Macrocephalae Rhizoma) large dose one packet, induce vomiting after taking. Chen/Si hours, Suoshi Sanhe Tang (Mr. Su's Three-Harmony Decoction) double dose plus Baizhu (Atractylodis Macrocephalae Rhizoma) two packets. After sleep, Shenyou Qi Wan (Divine Protection Seven Pills) to disturb phlegm, remove Qianniu (Pharbitidis Semen). Took for one month, stable.
Jin Shouyi Anren, 71, liked wet noodles, got Dai Xia (Leukorrhea) disease, also aversion to cold dripping. Doctor gave Heluaxu (Nelumbinis Plumula) Chaihu (Bupleuri Radix) etc., fever, discharge increased. Doctor gave Suosha (Amomi Fructus Rotundus) Doukou (Cardamomi Fructus) because low appetite; abdominal fullness, panting, gave Tingli San (Descurainiae Semen Lepidii Semis Decoction), ineffective. Gave Yuyuliang Wan (Yiyu Liang Pill), disease worsened. Doctor gave Chongtu San (Fortify Earth Powder), ineffective. My pulse: Both hands Hong and Choppy, light Wiry Long Slippery Solid, now panting severely unable to lie flat. Not damp酿成 (brewing) damp, in Foot Taiyin/Yangming meridians. Water/grain Qi suppressed by damp, unable to ascend, thus Dai Xia. Should use Sheng Ju (Ascending Lift) agents, tonify Qi, harmonize Blood. Doctor used astringent/dry agents, causing wandering disease. Gave Renshen (Ginseng Radix et Rhizoma) to generate Lung Yin to reject Fire Toxicity; Baizhu (Atractylodis Macrocephalae Rhizoma) to tonify Stomach Qi, drain Damp-Heat, move water passages; Tao Ren (Persicae Semen) to remove filth generate new; Yuliren (Prunus japonica Seed) to move accumulated water, assisted by Tongcao (Tetrapanacis Medulla); Xijiaoxie (Rhinocerotis Cornu) to resolve food toxicity, reduce swelling/oppression; Binglang (Arecae Semen) to treat highest Qi. Strong decoction swallow Baohe Wan (Harmonize the Stomach Pill). Suspected rich nourishment, meat accumulation, added Aw ei (Ferulae Resina) small pills to swallow. 4-5 days later, accumulated gas gradually reduced, swelling went down. Added Bushen Wan (Tonify Kidney Pill) to generate Kidney Water True Yin. 2-3 days later, gradually stable, slept, food tasted good. 2 days later, Dian Wan (Dot Pill) to drive out Lung accumulated heat, cured.
Man, Spleen Heat, Kidney Deficiency, Stomach Accumulation, swelling disease advancing/retreating, dry mouth or panting. Doctor months, not receding. Pulse Soft and Fine, fat body, not contraindicated. Used:
Baizhu (Atractylodis Macrocephalae Rhizoma) (4 qian); Shaoyao (Paeoniae Radix Alba), Dihuang (Rehmanniae Radix) (3 qian); Lianqiao (Forsythiae Fructus), Danggui (Angelicae Sinensis Radix) (2 qian); Qingpi (Citri Reticulatae Pericarpium Viride) (2.5 qian); Renshen (Ginseng Radix et Rhizoma), Mutong (Akebiae Caulis), Qianghuo (Notopterygii Rhizoma et Radix), Huangqin (Scutellariae Radix) (each 1.5 qian); Gancao (Glycyrrhizae Radix et Rhizoma), Honghua (Carthami Flos) (some).
Divide 5 doses, decoct, swallow Baohe Wan (Harmonize the Stomach Pill).
Yang Sheng, 30, malaria just calm, bland tofu vegetarian meal caused distension, above diaphragm, urine red/scant, no appetite, thirst, pulse Wiry and Choppy, Stomach has Blood Stasis. Used:
Sugeng (Perillae Caulis) (3 fen); Mutong (Akebiae Caulis) (0.5 qian); Baizhu (Atractylodis Macrocephalae Rhizoma) (1.5 qian); Chuanxiong (Ligustici Chuanxiong Rhizoma), Zhishi (Aurantii Fructus Immaturus), Baishao (Paeoniae Radix Alba) (each 5 fen); Gancao (Glycyrrhizae Radix et Rhizoma) (2 fen, prepared); Chenpi (Citri Reticulatae Pericarpium) (5 fen); Houpo (Magnoliae Officinalis Cortex) (3 fen).
Grind, Yi Yuan San (Benefit Origin Powder) swallow Baohe Wan (Harmonize the Stomach Pill) 50 pills.
Man, Qi ascends, belly distends, Lower Deficiency cause.
Chenpi (Citri Reticulatae Pericarpium) (5 qian); Renshen (Ginseng Radix et Rhizoma), Guixu (Angelicae Sinensis Radix Tip), Baizhu (Atractylodis Macrocephalae Rhizoma), Lianqiao (Forsythiae Fructus) (each 3 qian); Dihuang (Rehmanniae Radix), Shaoyao (Paeoniae Radix Alba) (each 2 qian); Mutong (Akebiae Caulis) (1.5 qian); Gancao (Glycyrrhizae Radix et Rhizoma) (5 fen).
Divide 5 doses, decoct, swallow Baohe Wan (Harmonize the Stomach Pill).
Muxiang Huazhi Tang (Aucklandia Transform Stagnation Decoction):
Baidoukou Ren (Cardamomi Fructus Kernel), Chenpi (Citri Reticulatae Pericarpium), Dafuzi (Arecae Semen), Baifuling (Poria cum Ligno Quercus), Sharen (Amomi Fructus), Renshen (Ginseng Radix et Rhizoma) (each 1 qian); Qingpi (Citri Reticulatae Pericarpium Viride), Binglang (Arecae Semen), Muxiang (Aucklandiae Radix), Jianghuang (Curcumae Longae Rhizoma) (each 2 qian); Baizhu (Atractylodis Macrocephalae Rhizoma) (1 qian); Gancao (Glycyrrhizae Radix et Rhizoma) (4 fen, prepared); Baitan (Santalum Album); Huoxiangye (Agastaches Folium) (each 2 fen); Jiegeng (Platycodonis Radix) (5 fen).
Fine powder, water 1 da zhang 2 fen, decoct to 1 da zhang, take slightly warm; before meals boil water point take also ok.
Above formulas, treat distension due to stagnation, all use Renshen/Baizhu/Houpo/Mutong decoction, tonify deficiency move dampness; swallow Shenyou/Awei pills to reduce accumulation, so-called Attack and Tonify combined.
Xiao Wen Zhong Wan (Minor Warm Middle Pill): Treats distension. Spleen deficiency cannot transport, do not purge.
Chenpi (Citri Reticulatae Pericarpium), Banxia (Pinelliae Rhizoma - boiled peel umbilicus), Shenqu (Massa Medicata Fermentata - fried), Fuling (Poria) (each 1 liang); Baizhu (Atractylodis Macrocephalae Rhizoma) (2 liang); Xiangfuzi (Cyperi Rhizoma - do not bake/dry); Zhensha (Magnetitum) (each 1.5 liang, vinegar fried red); Kushen (Sophorae Flavescentis Radix - fried); Huanglian (Coptidis Rhizoma - fried) (each 0.5 liang); Gancao (Glycyrrhizae Radix et Rhizoma) (3 qian).
Powder. Vinegar/Water each 1 da zhang, paste into pills, size tung zi. Each take 70-80 pills. Baizhu (Atractylodis Macrocephalae Rhizoma) 6 qian, Chenpi (Citri Reticulatae Pericarpium) 1 qian, Shengjiang (Zingiberis Rhizoma Recens) 1 slice, decoct swallow. Very deficient, add Renshen (Ginseng Radix et Rhizoma) 1 qian. Each formula remove Huanglian (Coptidis Rhizoma), add Houpo (Magnoliae Officinalis Cortex) 0.5 liang. Taboo diet. Light disease, take 6-7 liang, urine long; severe disease take 1 jin, urine begins long.
[Zhenheng] Yuyuliang Wan (Yiyu Liang Pill): Treats ten types of Water Qi, foot/knee swelling, upper body panting/fullness, urination difficulty. Any Water Qi, all govern. (Xu Xueshi and Danxi say: This formula is key drug for distension.)
Shehanshi (Depressorum Herba - large 3 liang, new iron pot, charcoal fire burn until yellow same red as pot, clamp take yellow, pour into vinegar, cool take, grind fine); Yuyuliang (Haematitum) (3 liang); Zhen Zhensha (Magnetitum) (5 liang, water wash clean, fry dry, put with Yuyuliang, rice vinegar 2 sheng pot boil until vinegar dry. Then pot and medicine charcoal fire red, clamp pour medicine clean brick ground, cool grind fine).
These three main, next measure person deficiency/excess add below: (Water treatment mostly takes rotation. Only this formula three items not comparable to Daji/Gansui/Yuanhua, plus below items support, so deficient/elderly can take)
Qianghuo (Notopterygii Rhizoma et Radix), Muxiang (Aucklandiae Radix), Fuling (Poria), Chuanxiong (Ligustici Chuanxiong Rhizoma), Niuxi (Achyranthis Bidentatae Radix - wine soak), Guixin (Cinnamomi Ramulus), Baidoukou (Cardamomi Fructus - processed), Dahuixiang (Foeniculi Fructus - fried), Pengzhu (Curcumae Rhizoma - processed), Fuzi (Aconiti Lateralis Radix Praeparata - processed), Ganjiang (Zingiberis Rhizoma - processed), Qingpi (Citri Reticulatae Pericarpium Viride), Jingsanleng (Sparganii Rhizoma - processed), Baijili (Tribuli Fructus), Danggui (Angelicae Sinensis Radix - wine soak overnight) (each 0.5 liang).
Powder, mix well, soup soaked steamed cake wring water, mix medicine pound uniform, pills tung zi size. Before meal, warm wine/white water send down 30-50 pills.
Most taboo salt, not a hair enter mouth, otherwise disease worse. Try medicine, immediately in urine go out, not move organs/zang-fu. Disease gone, 3 doses/day. Plus mild harmonize tonify Qi/Blood agents assist, truly divine formula.
[Danchi] Pulse firm/solid, person robust/sturdy, or can use attack drugs, then gather Baizhu (Atractylodis Macrocephalae Rhizoma) as main.
[Yuan] Zhongman (Middle Fullness) treatment: Kai Guimen (Open Ghost Gate), Jing Jingfu (Clean Pure Mansion). Kai Guimen is Fa Han (Induce Sweating); Jing Jingfu is Li Xiao Bian (Promote Urination). Also Zhongman Xie Yu Nei (Drain Middle from Inside), means Spleen/Stomach sick, let upper/lower separate dissipate its Qi. Lower Jiao like ditch, Qi/Blood naturally differentiate, no need to drain dregs, if Great Excess Great Fullness, urination/defecation not smooth, temporarily use Cold/Hot drugs to purge. Or damage wine/wet noodles, strong flavor things, Gao Liang (Rich/Fatty) people, or eat then lie down, make Damp-Heat Qi not transform, causing abdominal distension, this is also Re Zhang (Heat Distension). Treat Heat Distension, Fenxiao Wan (Separate Dissipate Pill) governs.
[Zhongjing] Qi Fen (Qi Division), Epigastric hardness, large as plate, edge like rotating cup, Water Drink caused, Guizhi Qu Shao Jia Mahan Fuzi Tang (Cinnamon Twig Decoction Remove Paeonia Add Ephedra, Asarum, Aconite Decoction) governs.
Guizhi (Cinnamomi Ramulus), Shengjiang (Zingiberis Rhizoma Recens) (3 liang), Gancao (Glycyrrhizae Radix et Rhizoma) (1 liang), Dazao (Ziziphi Jujubae Fructus) (12 pieces), Mahuang (Ephedrae Herba), Xixin (Asari Radix et Rhizoma) (each 2 liang), Fuzi (Aconiti Lateralis Radix Praeparata) (one piece, processed).
Seven ingredients, water 7 sheng, boil Mahuang remove foam, add others, boil to 2 sheng, divide warm, 3 doses. Should sweat, like insect walking in skin, then cured.
[Sheng] Niuhang Hupo Wan (Ox Gallstone Amber Pill): Treats edema abdominal large, breath not passing critical, divine effect.
Niuhuang (Bovis Calculus), Hupo (Electrum), Jiaomu (Zanthoxyli Semen - sinking), Tingli (Descurainiae Semen Lepidii Semis - fried purple) (each 3 fen); Kunbu (Laminariae Thallus - wash roast), Haizao (Sargassii Thallus - wash roast) (each 1 liang 1 qian); Qianniu (Pharbitidis Semen - fried), Gui (Cinnamomi Ramulus) (each 1 liang).
Seven ingredients powder, separately grind Tingli like mud, mix together, refine honey pills tung zi size. Each take 15 pills, rice drink down, limit by urination smooth, 2 doses/day.